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Type:	Artigo de Evento
Title:	Influence of medication regimen complexity on adherence: a systematic review
Authors:	Laís Lessa Pantuzza Maria das Graças Braga Ceccato Micheline Rosa Silveira Luane Mendes Ribeiro Junqueira Celline Cardoso Almeida Brasil Adriano Max Moreira Reis
Abstract:	Background: Having a high medication regimen complexity has been negatively associated to health outcomes, such as hospitalizations and poor quality of life. However, its influence on adherence has not been well established. Objectives: To systematically review and summarize the evidence regarding the association between medication regimen complexity and adherence in any pharmacotherapy. Methods: Articles were searched using MEDLINE, LILACS, Cochrane, CINAHL, PsycINFO and included studies references. Search terms included medication regimen complexity and medication adherence. Randomized clinical trials, cross-sectional, cohort or case-control studies published before March 2016 in English, Portuguese or Spanish languages were eligible if quantitatively examined the correlation between medication regimen complexity and medication adherence in patients of any age and sex, under any type of medication therapy. All type of instruments used to assess complexity and adherence were considered. Quality assessment was conducted independently using standard scales according of the study design. Results: Fifty-four studies met the inclusion criteria: 37 cross-sectional and 17 cohort studies. Most of them (51) were conducted in outpatient setting. Most frequently, the studies were carried out with HIV-infected individuals (10) or patients with chronic conditions: diabetes mellitus (7), epilepsy (3) and hypertension (2). Forty-two studies used only one method to assess complexity, the most frequent ones were a complexity index (18 studies), such as Medication Regimen Complexity Index and Antiretroviral Regimen Complexity Index, and the number of medications (13 studies). Among the instruments used to measure adherence, the most frequent was self-report (29). Regimen complexity was associated with medication adherence in 36 studies. Most of them (29 studies) identified that participants with more complex regimens were less likely to adhere to medication therapy; seven studies found a direct correlation, so that more complex regimens where related with higher adherence. The other studies found inconclusive results or no correlation between complexity and adherence. Conclusions: Although there was variability in studies’ conclusions regarding the correlation between medication regimen complexity and medication adherence, most of them showed a low to moderate-quality evidence that, regardless the type of pharmacotherapy, an increased regimen complexity reduces the probability of medication adherence.
Subject:	Medicamentos Adesão à medicação Complexidade do regime terapêutico
language:	eng
metadata.dc.publisher.country:	Brasil
Publisher:	Universidade Federal de Minas Gerais
Publisher Initials:	UFMG
metadata.dc.publisher.department:	FAR - DEPARTAMENTO DE FARMÁCIA SOCIAL FAR - DEPARTAMENTO DE PRODUTOS FARMACÊUTICOS
Rights:	Acesso Aberto
metadata.dc.identifier.doi:	https://doi.org/10.1002/pds.4275
URI:	http://hdl.handle.net/1843/46525
Issue Date:	22-Aug-2017
metadata.dc.url.externa:	https://onlinelibrary.wiley.com/doi/full/10.1002/pds.4275
metadata.dc.relation.ispartof:	International Conference on Pharmacoepidemiology & Therapeutic Risk Management
Appears in Collections:	Artigo de Evento

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